Personality Disorders

Personality disorders are common, interesting, ambiguous to diagnose, and can cause significant distress to the individual. There are lots of types and every person will almost certainly find traits in multiple categories which they feel reflect their own personality. But when is it a disorder?

Inflexible thought patterns

Repeated episodes of behaviour, which may be destructive - those with a personality disorder may end up in the same problematic situations over and over again even though they know it is not good for them

Longstanding impairment of functioning as a result of these difficulties in adapting thoughts and behaviours.

To diagnose a personality disorder, the sufferer must display significant distress or impairment across multiple situations - including personal, social, romantic, and occupational.

The sufferer of personality disorders often lead reasonably functional lives, but struggle with maintaining stable jobs, relationships or friendships. They may not seek psychological help, as their personality vulnerabilities are so integral to them as a person that they don't realise that they have a condition or that they can be helped.

When a mental health professional meets a client who they feel might have a personality disorder, they consider whether the client has any of four criteria. The diagnostic criteria state that they must have at least two, and they must be "significant" (having a major impact) and "enduring" (lasting for a long period of time).

Distorted thinking patterns

Problematic emotional responses

Over- or under-regulated impulse control

Interpersonal difficulties

They must also consider the individual characteristics that form the criteria for each disorder in order to propose that the client has one of the 10 personality disorders. Often they might fit into more than one category and end up with multiple diagnoses.

Discussing personality disorders as "clusters" is a matter of preference ans varies between healthcare networks, but for the purposes of education they are quite useful. A cluster is a group of similar disorders that share common characteristics are:

The common features of Cluster A disorders are social awkwardness and social withdrawal.

The Paranoid Personality Disorder

Distrust and suspicion of other people

This can be a belief that people want to harm, abuse, take advantage of or defame them in some way

They often get into a habit of protecting themselves from others both physically and emotionally and may even pre-empt perceived attacks

Find it very hard to confide in others

Often hold grudges and feel people's intentions are malevolent

They may struggle with relationships due to pathological jealousy

The Schizoid Personality Disorder

Social detachment and isolation

Narrow range of emotions/expression

"Loners" who prefer individual to group activities

Find it hard to digest both criticism and praise

Others might describe them as "cold" or detached

Difficulties understanding social expectations and relations so struggle to integrate

Schizotypal Personality Disorder

Social and interpersonal limitations

Isolative and distant, struggle with close one on one relationships

Experience semi-psychotic symptoms, but not to the extent that they reach the criteria for acute psychosis. These can include seeing lights or shadows in their vision, or having odd beliefs such as the ability to read other people's minds or other beliefs outside of social norms

Common traits: poor impulse control and emotional regulation. Can be dramatic, emotional, and erratic.

The Antisocial Personality Disorder

Do not respect the rights of other people or societal laws

Can appear hostile and/or aggressive

Can be deceiving and manipulative, and this often starts in childhood (ie bullying, juvenile convictions such as graffiti, arson, property damage)

Often starts as Conduct Disorder

May be involved in crimes, accidents, financial and legal difficulties in adulthold

Put selves at risk through lack of consideration of the consequences of their actions, and poor impulse control

Often can feign remorse if it is beneficial for them to do so

May partake in victim-blaming

Histrionic Personality Disorder

Very emotional people who often require the attention of others to validate their own distress

Question their own self worth if they are not the centre of attention

Can be perceived as flirtatious, theatrical, flamboyant

Might not be very good at displaying specific emotions, making them seem "fake" to others

This makes it hard for them to engage in truly intimate relationships because they struggle to show empathy over their own feelings, and in turn the other person feels they are not being heard. However, they can feel uncomfortable when they are alone.

Narcissistic Personality Disorder

Very entitled and feel they are highly important or significant

One if the few states of mind where people experience an inflated sense of self worth

Feel they should be treated in a different way to others, which can often seem disrespectful to an outside perspective and can be viewed as arrogant

May appear obsessed with success or beauty

Can be devastated if they are faced with evidence that they are not as special, successful or well liked as they believed

Often require the admiration of others to fuel their self image. Can be very manipulative to achieve this

Borderline Personality Disorder

Tend to experience intense and unstable emotions and moods that can shift quickly

Reduced ability to self-soothe and so if they get upset it's difficult to calm them down

Others may see angry outbursts that they don't understand or don't seem proportional

Other impulsive behaviours may include drugs, alcohol, risky sex, self-harm, overspending and overeating

They often recognise that these behaviours are destructive in the long term, and want to stop, but the draw and short-term gain is too overwhelming to stop

Often have a very black-and-white view of the world. For example, people are either good, or bad; their circumstances are either great or terrible, and there is little room for the grey area in the middle

Struggle to moderate their emotional reactions toward others because of this all-or-nothing response

This view often extends to their opinion of themselves which ends up being very unstable

Tend to regularly change significant life events, like their job, romantic partner, friends, accommodation, goals, etc. This further reduces their self of stability

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